Analysis of the repair process of osteonecrosis of the femoral head with a view to developing preventive methods for femoral head collapse

2022 Fiscal Year Final Research Report

• Project/Area Number: 19K09601
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 56020:Orthopedics-related
• Research Institution: Kyushu University
• Principal Investigator: Motomura Goro 九州大学, 医学研究院, 准教授 (50529857)
• Project Period (FY): 2019-04-01 – 2023-03-31
• Keywords: 大腿骨頭壊死 / 骨頭圧潰

Outline of Final Research Achievements

In osteonecrosis of the femoral head, a repair reaction starts after the occurrence of osteonecrosis, and osteosclerotic changes are observed in the necrotic boundary zone. The pathological analyses were conducted from the viewpoint that this repair process is the trigger of femoral head collapse, and we found that the stress distribution applied to the boundary zone differs depending on the presence or absence of osteosclerotic changes, and the fracture type caused by mechanical loading also differs, that collapse form differs depending on the presence of repair reaction, that bone mineral density in the necrotic zone is not reduced before collapse, and that the degree of repair reaction at the outer necrotic boundary of the head is related to the occurrence of subsequent collapse.

Free Research Field

股関節外科

Academic Significance and Societal Importance of the Research Achievements

特発性大腿骨頭壊死症の臨床における最大の課題は骨頭圧潰の予防であり、世界中で圧潰予防法の開発に凌ぎを削っている状況である。しかしながら、肝心の圧潰メカニズムは未だ不明であり、メカニズム解明のないままに細胞移植などによる再生治療が試みられているのが現状である。本研究成果は壊死境界域に骨硬化性変化を生ずる生体の修復反応こそが圧潰メカニズムの根幹であるという仮説を支持するものであり、圧潰予防法開発に向けた重要な知見が得られたと考えている。